Palliative and Supportive care

EGFRI-Related Skin Toxicity

Information, treatment algorithms and educational materials for healthcare professionals and patients about skin problems that may occur when being treated with anti-EGFR drugs

Multikinase Inhibitor Related Skin Toxicity

Information, treatment algorithms and educational materials for healthcare professionals and patients relating to the management of dermatological toxicities in patients treated with multikinase inhibitors.

Drug-Drug Interactions with Kinase Inhibitors

Information and education online resource for healthcare professionals on drug-drug interactions which can arise from the use of kinase inhibitors

Abstract

Background

Most information sheets cover the schedule of chemotherapy sessions and the adverse reactions of the respective drugs. However, the leaflets do not provide enough information instructing them how to take their supportive medications while at home for patients that have adverse drug reactions. We have developed a flowchart type leaflet to help improve the patients' adherence. The flowchart consisted of yes/no questions to guide how to take supportive medicine for adverse drug reactions or when patients should call to a hospital.

Objective

This study was designed to evaluate the benefits associated with the flowchart type leaflet (FC). [Subjects and methods] Subjects include head and neck cancer inpatients who received induction chemotherapy, TPF (docetaxel, cisplatin, and 5FU) or TPS (docetaxel, cisplatin, and S-1), from September 2009 to April 2012. Group A used FC while Group B did not use FC in their chemotherapy. A retrospective study was performed using patient records. The endpoints of this study were: (1) To determine the emergency hospital admissions/visits, (2) To determine the nonadherence, (3) To determine the telephone calls from patients.

Results

There were 49 patients and a total of 139 chemotherapy sessions in group A while there were 60 patients and a total of 163 chemotherapy sessions in group B with no significant differences in age, performance status, and their chemotherapy regimen. The results are: (1) Incidence of emergency hospital admission was significantly lower in group A compared to group B. (Group A v.s. Group B: 1% v.s. 10%, p < 0.01) (2) The nonadherence rate in supportive medication for adverse drug reactions due to chemotherapy was significantly lower in group A than group B (Group A v.s. Group B: 5% v.s. 23%, p < 0.01). (3) Telephone call rates were statistically significant in group A (16%, total 30 calls) compared to group B (7%, total 11 calls) in each chemotherapy regimen. Of the 30 telephone calls in group A, 24 calls (80%) were in a situation where patients needed to call a hospital and 5 calls (45%) in group B.

Conclusions

The FC could contribute to reducing emergency hospital admissions to prevent nonadherence and encourage patients' judgments in chemotherapy.